Not-For-Profit [501(c)(3)] Organization Application

The Federal Equipment Opportunity Act requires that all creditors, including banks, savings and loan associations, small loan companies, retail stores and others, make credit equally available to all credit-worthy customers without regard to sex or marital status, race, color, religion, national origin, age (provided applicant has the capacity to contract), receipt of income from a public assistance program and the good faith exercise of rights under the Consumer Credit Protection Act. The Federal Agency which administers compliance with this law concerning this bank is the Federal Deposit Insurance Corporation, 2345 Grand Avenue, Suite 1500, Kansas City, MO 64106. You have the right to receive reasons for adverse action taken as a result of an application for credit if you request it within sixty (60) days of such action.

The undersigned represents that all information provided with this Application is true and correct and hereby authorizes Impact Leasing Solutions, Inc. to verify and obtain from third parties, information it deems necessary to arrive at a decision regarding this Application. By signing below, the undersigned individual as principal of the applicant; 1) authorizes Impact Leasing Solutions, Inc., its designee, assigns or potential assigns, including any credit bureau or other investigative agency employed by Impact Leasing Solutions, Inc. to review and investigate the references herein listed or statements or other data obtained from me or from any other person pertaining to my credit and financial responsibility in considering this Application and for the purpose of update, renewal, or extension of credit to the Applicant or the collection of any resultant accounts, and 2) authorizes all deposit, borrowing, financial and trade information to be released to Impact Leasing Solutions, Inc. by telephone, fax or email. A photocopy or fax of this authorization shall be valid as the original.

Failure to consummate this transaction once granted credit approval with lease documents drafted and delivered to the Lessee will result in a documentation fee being assessed to the Lessee. This fee will NOT be charged if the transaction if funded via Impact Leasing Solutions, Inc. as agreed.